Improving the health of communities begins by understanding the needs of community members. It is important that individual identities be explored in an effort to learn how norms, values, and practices manifest. Cultural Competency and Health Literacy trainings provide opportunities for individuals to explore the intersectionality of identities, and how it relates to organizational development and practices.

Cultural competency and health literacy trainings can afford organizations with the ability to:

Assess themselves in terms of their own identities, personal beliefs, values, and customs.

Assess and implement practices and policies of the organization.

Identify existing community needs by understanding how systems and structures relate to health outcomes.

Forecast growing needs in your community.

Develop and implement inclusive practices such as the use of interpreters or the creation of health promotion materials for certain populations.3

CCHL and Delivery System Reform Incentive Program (DSRIP)

In an effort to improve healthcare, the New York State Department of Health sees Participating Provider Systems (PPS), such as Millennium Collaborative Care, as agents of change:

[The] overall Delivery System Reform Incentive Program (DSRIP) and local Participating Provider Systems (PPS), hinges on all facets of the PPS achieving cultural competency and improving health literacy. Each PPS must demonstrate cultural competence by successfully engaging Medicaid members from all backgrounds and capabilities in the design and implementation of their health care delivery system transformation. The ability of the PPS to develop solutions to overcome cultural and health literacy challenges is essential in order to successfully address healthcare issues and disparities of the PPS community.1

Cultural Competency

Cultural Competency has been defined by the Office of Minority Health as a set of congruent behaviors, attitudes, and policies that come together in a system, agency or among professionals and enable that system, agency or those professions to work effectively in cross-cultural situations.2,3

An effective cultural competency program must address two components, culture and competence:

Culture refers to integrated patterns of human behavior that include thoughts, communication, actions, customs, beliefs, values and institutions of a racial, ethnic, religious or social groups.2

Competence implies having the capacity to function effectively.2

By placing an emphasis on culture and competence, attitudes, skills, and knowledge can be addressed within five essential elements:

Valuing diversity.

Having the capacity for cultural self-assessment.

Being conscious of the dynamics inherent when cultures interact.

Having institutionalized culture knowledge.

Adapting the delivery of services to be culturally inclusive.4

These five elements should be implemented at every level of an organization including policy making, administration, and practice. Furthermore, these core elements should be considered when hiring new employees, communicating with new or existing patients, developing programs, and when interacting with the community. Becoming culturally competent is an ongoing process that does not have a set endpoint; there must be a constant assessment of systems, structures, and policies.2

Health Literacy

Health literacy as defined by The Center for Disease Control and Prevention is the degree to which individuals have the capacity to obtain, process and understand basic health information needed to make appropriate health decisions. Low health literacy may be associated with limited English proficiency, cultural barriers, low educational skills, and health care and human service providers having limited understanding of an individual’s needs.5

Improving the health literacy of patients and community members requires that organizations:

Identify the intended users of health promotional material distributed or displayed.
a. Organizations need to design or amend materials and protocols to the characteristics, demographics, literacy skills, culture, and other factors of those they serve.

Acknowledge and respect cultural differences of those served.
a. Organizations must consider how factors such as race, ethnicity, nationality, language, customs, gender, socioeconomic status, and age may result in barriers to care. For example, if your organization serves a large Burmese population, materials should be translated into Burmese, Karen or another language specific to those you serve.

Use plain language.
a. Break information down into understandable terms. Engage patients so they will ask questions to further understand.

Make information accessible.
a. Consider the various factors and experiences of those you serve. What is the best way to communicate information? Is it fliers, web content, having additional resources available.5

Agency for Healthcare Research and Quality
a. Provides their Health Literacy Universal Precautions Toolkit for primary care practices that includes steps organizations should take when they believe a patient has low health literacy. This toolkit aims to increase patient understanding of health information and improve support for patients of different health literacy levels.

Language of Caring
a. A partnership that provides assessments, planning, leadership development, speeches, workshops, and webinars for healthcare organizations in order to improve their communication skills for patient care.

CDC: Health Literacy
a. The CDC supplies tools, information, and other links on health literacy practice, research, and evaluation for public health issues.